Misuse of prescription opioids is a public health issue. In the United States (US), over two million adults annually abuse such drugs (1). By 2008, approximately 14 million people aged 12 years or older used oxycodone in their lifetime for non-medical purposes (2). Consumption of hydrocodone doubled and for oxycodone it increased by nearly 500% between 1999-2011 (3).Prescription pain medications are easily accessible; some erroneous conceptions regarding their side effects and abuse potential, enhanced a dramatic increase in the non-medical use of prescription opioids (4). About two million Americans were dependent on and/or abused these drugs during 2014 (2).

Drug overdose deaths have increased in recent years. In 2010, 75% of fatalities due to pharmaceutical overdoses were caused by prescription-opioid analgesics (5). Such morbidity has dramatically escalated (6,7).

Clinical

The people using prescription opioids are have different characteristics than those abusing other opioid formulations, like heroin. These persons are commonly younger and Caucasian. Usage is less frequent and less often by the intravenous route. This community is more affluent, financially stable, and with less social concerns (1).

Clinical features of opioid toxicity include miosis, respiratory and central nervous system depression, bradycardia, coma, and death (8). Oxycodone can induce QT prolongation and/or Torsade de Pointes (9). Opioids often cause constipation with the bowel dysfunctions of abdominal pain, fullness, nausea, and ileus. Frequent falls occur among the older age individuals and a neonatal abstinence syndrome for new-borns. Human immunodeficiency and hepatitis viruses can co-present in anyone who utilizes non-sterile intravenous administrations (10,11).

Legally prescribed opioids are sometimes misused for non-medical reasons (13). Substitutes like methadone, buprenorphine, and levo-alpha-acetylmethadol are available for the treatment of those who develop opioid addiction (1). A competitive opioid antagonist, naloxone, can be prescribed to reverse opioid overdose effects, especially respiratory suppression (14).

Educating prescribers is an aid to control overuse. Various state laws and restrictive insurance policies about opioid prescribing dosage and duration can also help. Such systematic approaches hopefully will help prescribers provide safer care (13).

Conclusion

Abuse of prescription opioids has been rising. These analgesics are initially prescribed to patients for pain relieve. The number of deaths due to prescription opioid analgesics has been increasing. Misinterpretations about medication safety and easy availability have compounded this problem.

Life-saving respiratory depression is potentially reversed by naloxone administration. In order to prevent and overcome the opioid abuse crisis, the recommended preventative plans should be beneficial.

US department of health and human services, substance abuse and mental health services administration. Available at https://www.samhsa.gov/sites/default/files/samhsa_cj2009.pdf Last accessed: August 28, 2017

Jones CM. Trends in the distribution of selected opioids by state, US, 1999–2011. In National Meeting Safe State Alliance 2013. Last accessed: August 28, 2017